ABSA SURGICAL ASSISTANT CERTIFICATION (SA-C) EXAM
(PDF) | 2026 QUESTIONS & ANSWERS + RATIONALES |
STUDY GUIDE | 100% CORRECT
1. Which of the following best describes the primary responsibility of the first assistant during a
surgical procedure?
A) Passing instruments to the surgeon
B) Counting sponges and needles
C) Providing exposure, hemostasis, and tissue manipulation
D) Managing the anesthesia machine
Correct Answer: C) Providing exposure, hemostasis, and tissue manipulation
Rationale: The first assistant provides active participation during surgery, including exposure,
hemostasis, and suturing as determined by the primary surgeon. They cannot serve as a scrub or
pass instruments while acting as the first assistant .
2. According to the Joint Commission Universal Protocol, what three elements must be
confirmed during the preoperative "time out" procedure?
A) Patient age, diagnosis, and insurance status
B) Correct patient identity, correct procedure, and correct surgical site
C) Surgeon name, anesthesia type, and operative duration
D) Blood type, allergies, and fasting status
Correct Answer: B) Correct patient identity, correct procedure, and correct surgical site
Rationale: The Universal Protocol mandates a preoperative "timeout" verifying correct patient
identity, correct procedure, and correct surgical site (including laterality) to prevent wrong-site,
wrong-procedure, and wrong-person surgery .
3. A patient is undergoing a colon resection and has poorly controlled diabetes mellitus with a
blood glucose of 280 mg/dL. The surgical assistant should recognize that this finding increases
the risk for which complication?
A) Malignant hyperthermia
B) Surgical site infection and poor wound healing
C) Venous thromboembolism only
D) Anaphylaxis to antibiotics
Correct Answer: B) Surgical site infection and poor wound healing
Rationale: Hyperglycemia impairs neutrophil function and collagen synthesis, increasing
infection risk and delaying wound healing. Elective surgery may be postponed to improve
glycemic control .
4. Which anatomical structure is located within the "Triangle of Calot" and is a critical landmark
during cholecystectomy?
A) Common bile duct
,B) Cystic artery
C) Portal vein
D) Hepatic artery
Correct Answer: B) Cystic artery
Rationale: The Triangle of Calot is bounded by the cystic duct, common hepatic duct, and cystic
artery. The cystic artery is the critical structure located within this triangle that must be identified
and secured during cholecystectomy .
5. During a thyroidectomy, which cranial nerve is at greatest risk of injury?
A) Hypoglossal nerve (CN XII)
B) Recurrent laryngeal nerve (branch of CN X)
C) Glossopharyngeal nerve (CN IX)
D) Facial nerve (CN VII)
Correct Answer: B) Recurrent laryngeal nerve (branch of CN X)
Rationale: The recurrent laryngeal nerve, a branch of the vagus nerve, provides motor
innervation to the intrinsic laryngeal muscles and is at significant risk during thyroid and
parathyroid surgery, potentially causing vocal cord paralysis .
6. A patient has a documented allergy to latex. What action should the surgical assistant take
when setting up the operating room?
A) Wear standard gloves but avoid latex drapes
B) Remove all latex-containing products from the room and use latex-safe alternatives
C) Only avoid latex gloves
D) Use a latex-free prep solution only
Correct Answer: B) Remove all latex-containing products from the room and use latex-safe
alternatives
Rationale: A latex allergy requires complete avoidance of all latex products, including gloves,
drapes, catheters, and tourniquets. Non-latex alternatives should be used throughout the surgical
procedure .
7. Which of the following positions is used for a thyroidectomy to provide optimal surgical
exposure?
A) Supine with a roll under the knees
B) Reverse Trendelenburg with a shoulder roll
C) Prone with head fixation
D) Lateral decubitus with kidney rest
Correct Answer: B) Reverse Trendelenburg with a shoulder roll
Rationale: Reverse Trendelenburg with a shoulder roll extends the neck to provide optimal
exposure for thyroidectomy. This position elevates the surgical site above the heart, reducing
venous congestion .
, 8. When a sterile person folds their arms, what happens to the sterility of their gloves?
A) They remain sterile indefinitely
B) They are considered contaminated
C) They become sterile again when unfolded
D) Only the palms remain sterile
Correct Answer: B) They are considered contaminated
Rationale: When a sterile person folds their arms, the gloves are no longer considered sterile
because they have been placed in a non-sterile position near the armpits area. The hands should
remain clasped in front of the body above waist level to maintain sterility .
9. The presence of only one living microorganism means an object is:
A) Sterile
B) Clean
C) Contaminated
D) Disinfected
Correct Answer: C) Contaminated
Rationale: Sterility means the complete absence of all living microorganisms. The presence of
even one living microorganism renders an object contaminated .
10. Which statement concerning masks is NOT true?
A) Masks should cover both nose and mouth
B) Ties may be tied crisscross on top of head
C) Masks should be changed between cases
D) Masks are worn to protect the patient from the surgical team
Correct Answer: B) Ties may be tied crisscross on top of head
Rationale: Mask ties should be tied securely at the back of the head, not crisscrossed on top. The
upper ties are tied at the crown of the head and lower ties at the neck for a secure fit .
11. In draping a table, the scrub nurse drapes from _____ to _____ protecting her gloves by
_____.
A) Front, back, cupping
B) Back, front, cradling
C) Front, back, cuffing drape edge
D) Back, front, holding tightly
Correct Answer: C) Front, back, cuffing drape edge
Rationale: The scrub nurse drapes from front to back, protecting gloved hands by cuffing the
drape edge over the hands. This prevents contamination of gloves during the draping process .
12. The purpose of the hand scrub by the team is to render their skin:
A) Sterile
B) Surgically clean
(PDF) | 2026 QUESTIONS & ANSWERS + RATIONALES |
STUDY GUIDE | 100% CORRECT
1. Which of the following best describes the primary responsibility of the first assistant during a
surgical procedure?
A) Passing instruments to the surgeon
B) Counting sponges and needles
C) Providing exposure, hemostasis, and tissue manipulation
D) Managing the anesthesia machine
Correct Answer: C) Providing exposure, hemostasis, and tissue manipulation
Rationale: The first assistant provides active participation during surgery, including exposure,
hemostasis, and suturing as determined by the primary surgeon. They cannot serve as a scrub or
pass instruments while acting as the first assistant .
2. According to the Joint Commission Universal Protocol, what three elements must be
confirmed during the preoperative "time out" procedure?
A) Patient age, diagnosis, and insurance status
B) Correct patient identity, correct procedure, and correct surgical site
C) Surgeon name, anesthesia type, and operative duration
D) Blood type, allergies, and fasting status
Correct Answer: B) Correct patient identity, correct procedure, and correct surgical site
Rationale: The Universal Protocol mandates a preoperative "timeout" verifying correct patient
identity, correct procedure, and correct surgical site (including laterality) to prevent wrong-site,
wrong-procedure, and wrong-person surgery .
3. A patient is undergoing a colon resection and has poorly controlled diabetes mellitus with a
blood glucose of 280 mg/dL. The surgical assistant should recognize that this finding increases
the risk for which complication?
A) Malignant hyperthermia
B) Surgical site infection and poor wound healing
C) Venous thromboembolism only
D) Anaphylaxis to antibiotics
Correct Answer: B) Surgical site infection and poor wound healing
Rationale: Hyperglycemia impairs neutrophil function and collagen synthesis, increasing
infection risk and delaying wound healing. Elective surgery may be postponed to improve
glycemic control .
4. Which anatomical structure is located within the "Triangle of Calot" and is a critical landmark
during cholecystectomy?
A) Common bile duct
,B) Cystic artery
C) Portal vein
D) Hepatic artery
Correct Answer: B) Cystic artery
Rationale: The Triangle of Calot is bounded by the cystic duct, common hepatic duct, and cystic
artery. The cystic artery is the critical structure located within this triangle that must be identified
and secured during cholecystectomy .
5. During a thyroidectomy, which cranial nerve is at greatest risk of injury?
A) Hypoglossal nerve (CN XII)
B) Recurrent laryngeal nerve (branch of CN X)
C) Glossopharyngeal nerve (CN IX)
D) Facial nerve (CN VII)
Correct Answer: B) Recurrent laryngeal nerve (branch of CN X)
Rationale: The recurrent laryngeal nerve, a branch of the vagus nerve, provides motor
innervation to the intrinsic laryngeal muscles and is at significant risk during thyroid and
parathyroid surgery, potentially causing vocal cord paralysis .
6. A patient has a documented allergy to latex. What action should the surgical assistant take
when setting up the operating room?
A) Wear standard gloves but avoid latex drapes
B) Remove all latex-containing products from the room and use latex-safe alternatives
C) Only avoid latex gloves
D) Use a latex-free prep solution only
Correct Answer: B) Remove all latex-containing products from the room and use latex-safe
alternatives
Rationale: A latex allergy requires complete avoidance of all latex products, including gloves,
drapes, catheters, and tourniquets. Non-latex alternatives should be used throughout the surgical
procedure .
7. Which of the following positions is used for a thyroidectomy to provide optimal surgical
exposure?
A) Supine with a roll under the knees
B) Reverse Trendelenburg with a shoulder roll
C) Prone with head fixation
D) Lateral decubitus with kidney rest
Correct Answer: B) Reverse Trendelenburg with a shoulder roll
Rationale: Reverse Trendelenburg with a shoulder roll extends the neck to provide optimal
exposure for thyroidectomy. This position elevates the surgical site above the heart, reducing
venous congestion .
, 8. When a sterile person folds their arms, what happens to the sterility of their gloves?
A) They remain sterile indefinitely
B) They are considered contaminated
C) They become sterile again when unfolded
D) Only the palms remain sterile
Correct Answer: B) They are considered contaminated
Rationale: When a sterile person folds their arms, the gloves are no longer considered sterile
because they have been placed in a non-sterile position near the armpits area. The hands should
remain clasped in front of the body above waist level to maintain sterility .
9. The presence of only one living microorganism means an object is:
A) Sterile
B) Clean
C) Contaminated
D) Disinfected
Correct Answer: C) Contaminated
Rationale: Sterility means the complete absence of all living microorganisms. The presence of
even one living microorganism renders an object contaminated .
10. Which statement concerning masks is NOT true?
A) Masks should cover both nose and mouth
B) Ties may be tied crisscross on top of head
C) Masks should be changed between cases
D) Masks are worn to protect the patient from the surgical team
Correct Answer: B) Ties may be tied crisscross on top of head
Rationale: Mask ties should be tied securely at the back of the head, not crisscrossed on top. The
upper ties are tied at the crown of the head and lower ties at the neck for a secure fit .
11. In draping a table, the scrub nurse drapes from _____ to _____ protecting her gloves by
_____.
A) Front, back, cupping
B) Back, front, cradling
C) Front, back, cuffing drape edge
D) Back, front, holding tightly
Correct Answer: C) Front, back, cuffing drape edge
Rationale: The scrub nurse drapes from front to back, protecting gloved hands by cuffing the
drape edge over the hands. This prevents contamination of gloves during the draping process .
12. The purpose of the hand scrub by the team is to render their skin:
A) Sterile
B) Surgically clean
